Featuring – The Unstable Shoulder Protocol

Anterior shoulder instability and impingement are common athletic complaints associated with overuse, joint laxity, post-traumatic dislocation and muscle imbalance. While traditionally treated as clinically discrete entities, it is now accepted that considerable overlap exists between functional instability and anterior impingement(1-3).Until recently, rehabilitation programs have emphasized subscapularis strengthening on the assumption that this muscle provided an anterior buttress, preventing anterior humeral head subluxation(4-6). Turkel (1981) has demonstrated inability of the subscapularis to cover the anterior humeral head in abduction and external rotation(7) and Garth reports that internal rotation forces actually contribute to anterior displacement(2). These findings provide an explanation for high failure rates of traditional rehabilitation programs(8-11).